United Health Careers – Claims Clerk

Job Description:

The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.

Job Responsibilities:

• Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
• Consistently meet established productivity, schedule adherence, and quality standards
• Analyze and identify trends and provide reports as necessary
• Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
• Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
• Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
• Authorize the appropriate payment or refers claims to investigators for further review.
• Updates and maintains claims tracking database
• Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
• Calculate other insurance and re-pricing benefits

Job Requirements:

• Experience with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Basic understanding of healthcare claims including ICD-9 and CPT codes
• 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
• High school diploma / GED (or higher)
• 2+ years of data entry experience

Job Details:

Company:  UnitedHealthcare

Vacancy Type:  Full Time

Job Location: Dallas, TX, US

Application Deadline: N/A

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